Naturally perimenopausal or postmenopausal women are at a  higher risk of developing diabetes, according to a recent study reported in the journal Nutrition & Metabolism.¹

Researchers prospectively analyzed data from the China Kadoorie Biobank study involving 302,522 women aged 30-79 years from 10 areas across China from 2004 to 2008 to examine associations of menopausal status with the risk of diabetes. The present study enrolled 281,319 women. Women with a history of surgical menopause, cancer, lack of data on menopausal status or self-reported or screen-detected diabetes were excluded. New onset diabetes was the primary outcome measure of the study. Half (50.4%) of the women in the study group were postmenopausal, while 44.6% were premenopausal and 5.0% were perimenopausal. The mean age of attaining natural menopause was 48.2 years.

In comparison to the naturally pre-menopausal women, the peri and postmenopausal women were likely to be less well educated, residing in urban areas, more sedentary, smokers, overweight/obese particularly central obesity, oral contraceptive pills (OCP) users, multiparous; they also had higher age at menarche and breastfed their children for longer periods. Women with early menopause tended to be younger, lean, more active, smokers, nulliparous, living in rural areas and have lower menarche age and lack of breastfeeding.

A total of 11,459 women developed diabetes during the mean follow-up period of 10.8 years (3,050,083 person-years of follow-up).

Compared with premenopausal women, the perimenopausal women were at higher risk of diabetes with hazard ratio (HR) of 1.17. A similar high risk was observed among postmenopausal women with HR of 1.15. Among the postmenopausal women who reached menopause naturally, “the HR of diabetes was 1.14, 1.01, 1.10 and 1.10 for menopause at ages less than 40, 40-44, 50-53 and ≥54 years, respectively, relative to 45-49 years”.

This study has demonstrated the association of menopausal status with risk of diabetes. The naturally peri-, or post-menopausal women are at a much higher risk of developing incident diabetes compared to their premenopausal counterparts. And, among the postmenopausal women, early menopause and those who attained menopause at a later age were at a higher risk of diabetes. The menopausal transition period has been suggested to be a “window of vulnerability or risk”. Close monitoring particularly during this critical period can ward off or reduce the risk of diabetes making it also a “window of opportunity” for timely interventions.

Reference

1. Wang M, et al. Menopausal status, age at natural menopause and risk of diabetes in China: a 10-year prospective study of 300,000 women. Nutr Metab (Lond). 2022 Feb 5;19(1):7. doi: 10.1186/s12986-022-00643-x.